Please wait

Please note that the information on this website is now out of date. It is planned that we will update and relaunch, but for now is of historical interest only and we suggest you visit cqc.org.uk

Inspection on 07/10/08 for Langfield Nursing And Residential Home

Also see our care home review for Langfield Nursing And Residential Home for more information

This inspection was carried out on 7th October 2008.

CSCI found this care home to be providing an Good service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Potential service users` needs are assessed before they or the manager make a decision that the home is suitable to meet their needs. Service users have access to the full range of medical services available in the community. Staff maintain good professional relationships with professionals outside of the home. Service users have their dignity maintained and are treated respectfully by staff. Visitors are made to feel welcomed by the staff. The provision of food is good, offering a balanced diet with choice and ample proportions. Accommodation is safe, clean and well maintained, offering a variety of communal areas as well as individual`s own bedrooms. Staff and management work well to meet the needs of service users in a pleasant atmosphere. Comments made by service users and visitors during the site visit were very positive about the attitude of the staff team. Comments from relatives included : "Staff are very friendly" ; "Staff are welcoming -- time to speak [to you]" and "These girls are angels ... always cheerful". Service users said "[it`s] like being in your own home, there are no restrictions", "they will do anything for you. You only have to ring and they are there" and "Staff are brilliant and look after you very very well. They are lovely ... they really are wonderful"

What has improved since the last inspection?

Social activities and social contact in the community have significantly improved since the last key inspection.

What the care home could do better:

Some administrative issues were not undertaken as thoroughly as they should be. These included some medication recordings and some updating of care plans. While this did not present as having an immediately detrimental impact on service users it did have a negative impact on the home`s ability to be accountable for their care and safety. Similarly complaints or investigations should be more thoroughly recorded. Another aspect of administration which could be improved was maintaining thorough records to demonstrate all aspects of any applicant to join the staff team is appropriately vetted. The quality assurance system should result in a report which identifies how any improvements can be made to the service for the benefit of service users. This report should be available for service users and their representatives to demonstrate that their views are acted on.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Langfield Nursing And Residential Home Wood Street Langley, Middleton Manchester Lancashire M24 5QH     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Steve Chick     Date: 1 0 1 0 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: · · · · Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: Langfield Nursing And Residential Home Wood Street Langley, Middleton Manchester Lancashire M24 5QH 01616535319 01616535393 langfield@schealthcare.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Beverley Josephine Unsworth Type of registration: Number of places registered: Southern Cross Care Management Limited care home 50 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia old age, not falling within any other category physical disability Additional conditions: The registered person may provide the following category of service only: Care home with nursing: Code N, to service users of the following gender: Either. Whose primary care needs on admission to the home are within the following categories: Mental disorder, excluding learning disability or dementia: Code MD (maximum number of places: 1 female). Old age, not falling within any other category: Code OP (maximum number of places: 50). Physical disability: Code PD (maximum number of places: 2 male). The maximum number of service users who can be accommodated is: 50. Date of last inspection 1 0 2 Over 65 0 50 0 Care Homes for Older People Page 4 of 28 Brief description of the care home Langfield Care Home is a purpose built home with 2 units, which caters for 50 residents with a variety of needs. There is a residential unit on the first floor and nursing unit on the ground floor. The home is situated in a residential area in Middleton and is on the main bus route. A local shop, post office and public house are close to the home. It is situated in its own grounds and has gardens to the side and rear with ample parking at the front of the home. Accommodation is provided on two floors in 50 single bedrooms. All but one has en-suite facilities. Level access to the home is provided and a passenger lift ensures access is provided to both floors. Five lounges and three dining rooms are available and the communal rooms on the ground floor allow access to the garden and patio area. Fees charged by the home as at October 2008 were reported as ranging from £352.00 to £481.00. Up to date information about the fees can be obtained from the home. Personal items such as newspapers, hairdressing and chiropody are not included in the price. Care Homes for Older People Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is two star. This means the people who use this service experience good quality outcomes. We (the Commission for Social Care Inspection) undertook a key inspection, which included an unannounced visit to the home. This meant that no one at Langfield knew that the visit was going to take place. To help with this inspection three service users were interviewed in private, as were four relatives of service users. Additionally discussions took place with the manager and three staff members were interviewed in private. Care Homes for Older People Page 6 of 28 All the key inspection standards were assessed at the site visit. Information was obtained from various sources, which included talking with people who live at the home, the manager, visitors and other members of the staff team. We also looked at information we have about how the service has managed any complaints, what the service has told us about things that have happened in the service, these are called notifications, and any relevant information from other organisations. Before the site visit, we asked for surveys to be sent out to staff, asking what they thought about the care at the home. Four completed staff surveys were received by us. Some of the information from these surveys is included in the report. We also asked the management of the home to fill in a questionnaire, called an Annual Quallity Assurance Assessment (AQAA). This is a legal requirement. The AQAA told us what they thought they did well, what they need to do better and what they have improved upon. Where appropriate, some of these comments have been included in the report. We undertook a tour of the building and looked at a selection of service user and staff records as well as other documentation, including staff rotas, medication records and the complaints log. We had received information about one safeguarding concern since our last Key inspection. This had been responded to appropriately by the management of the home. What the care home does well: What has improved since the last inspection? What they could do better: Some administrative issues were not undertaken as thoroughly as they should be. These included some medication recordings and some updating of care plans. While this did not present as having an immediately detrimental impact on service users it did have a negative impact on the homes ability to be accountable for their care and safety. Similarly complaints or investigations should be more thoroughly recorded. Another aspect of administration which could be improved was maintaining thorough records to demonstrate all aspects of any applicant to join the staff team is appropriately vetted. The quality assurance system should result in a report which identifies how any improvements can be made to the service for the benefit of service users. This report should be available for service users and their representatives to demonstrate that their views are acted on. Care Homes for Older People Page 8 of 28 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 28 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users needs are appropriately assessed and they, or their representatives, are able to visit before a decision is made that the home is appropriate for them and can meet their needs. Evidence: The manager told us that each service user had an assessment before being admitted into the home and that they or their families were encouraged to visit before making a choice to move in. During the unannounced site visit a selection of service users files was looked at. All had documentary evidence of an assessment which had been undertaken before the service user moved to Langfield. Relatives and service users who were asked, confirmed that staff at Langfield had assessed the service user before a place was confirmed. Care Homes for Older People Page 11 of 28 Evidence: One relative said he was impressed that no appointment was needed for the initial visit to the home. He also said that the manager was very helpful at that visit and gave him written information to take away. Langfield does not offer intermediate treatment. Care Homes for Older People Page 12 of 28 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users health, personal and social care needs are met by the consistent implementation of policies and procedures. Staff practices also serve to promote the dignity of the service users. Evidence: The manager told us that all residents have individual care plans, that residents and relatives are involved in that process and that they are regularly reviewed. The manager also reported in the AQAA that appropriate policies and procedures are in place in respect of the safe storage and administering of medication and that staff were trained to treat residents with dignity and respect. At this visit a selection of service users files was looked at. All had documentary evidence of a service user plan which was regularly reviewed. There was also some documentary evidence that service users or their representatives were involved in that care planning process. Examples were seen where changes had been observed and recorded but the actual care plan had not been updated, leaving potentially inaccurate Care Homes for Older People Page 13 of 28 Evidence: guidance for staff. No evidence was seen where this had caused any problems for any service users. Staff who were interviewed confirmed that in addition to the written records they were informed of changes verbally, and got to know the service users individually. Staff who were interviewed and staff who completed surveys indicated that the system for passing information on generally worked well. One visiting professional was interviewed who reported positively on communication with the staff team. Their experience was that care plans presented as being up to date, staff were always available for reviews and that overall they were very satisfied with the support they and their patient received. Service users who were spoken to were positive about the way in which their care needs were met by the staff team. One person described the way that she was bathed as marvellous. The service user also said they will do anything for you. You only have to ring and they are there. Relatives who were spoken to were also positive about the care offered, and the effective communication between the home and themselves. One relative said that they were definitely consulted regarding the care planning process and that she was confident she would be contacted, by the staff, whenever necessary. There was good documentary evidence that service users had access to the full range of medical services available in the community. All staff, service users and visitors who were asked expressed the view that medical support was appropriately obtained in a timely manner. Evidence was seen of daily records, relating to one service user, which identified a possible health problem. Records following this noted staff observations, an appropriate referral to a general practitioner and the necessary follow up being undertaken. This was good recording as it clearly demonstrated action taken and the reason for the action. Medication presented as being stored appropriately. There was documentary evidence that the medication administration records were regularly audited by the manager and that any errors were addressed. A small sample of the medication administration records was looked at. In the main they presented as being appropriately maintained, but in one example seen, a signature was missing with no explanation as to why. this made it difficult to tell if the service user had been given the medication or not. This had occurred since the managers last audit and they undertook to investigate this matter. There was documentary evidence that further medication training was planned for staff for the end of the month of October. Care Homes for Older People Page 14 of 28 Evidence: All service users, visitors and staff who were asked, reported that people living at the home were treated with respect and that their dignity was maintained. Care Homes for Older People Page 15 of 28 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Appropriate social contacts and activities are facilitated within the home to give service users the opportunity for social fulfilment. Dietary needs of service users are well catered for with a balanced and varied selection of food to meet service users tastes and choices. Evidence: The AQAA provided by the manager indicated that an activities coordinator had been appointed since then, and that more links had been developed with the local community. At this inspection visit it was reported by the manager, and confirmed by staff, that the activities coordinator had recently gone off sick. During this period staff were endeavouring to maintain a programme of activities. There was a programme of activities on the noticeboard including outings to a local community centre and pamper days . No service user who was talked to at this visit expressed concerns about the level of activities available. One confirmed that they had enjoyed playing games that day Care Homes for Older People Page 16 of 28 Evidence: whilst another said they did not wish to take part in the activities although she was aware that they were available. It was evident from observation and discussion with service users that they could choose where to spend their time during the day, either in their own room or in communal areas. Quiet lounges were available where a television was not on. One service user, when asked what the best thing about the home was, said its like being in your own home, there are no restrictions. Another service user said that the best thing about the home was that staff were free and easy with their routine. Discussion with service users and visitors confirmed that visitors were welcomed at any reasonable time. Visitors experienced being welcomed at the home and said that the staff were friendly and had time to speak to them. One visitor said that a relative of theirs had been able to sleep over at the home during a time when their relative was quite ill. There was evidence of a written menu which varied on a two-week cycle and offered a choice at each main meal time. One meal was sampled at this visit which was pleasantly presented and tasty. Service users were positive about the food. One service user said the meals were always nice and hot and well presented. Service users could choose to have meals in their room or in the dining area. Visitors who were asked also reported positively on the food provided. One visitor described the food as brilliant and said that they had a regular meal at the home themselves and could go and brew up whenever they wished. Care Homes for Older People Page 17 of 28 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users are protected from abuse or exploitation by the homes policies and practices and are confident that any complaint they may have would be dealt with appropriately. Evidence: The manager reported via the AQAA that there was a managers surgery where she was available for anyone to talk to, and a monthly audit was undertaken which incorporated an assessment of any complaints made. She also reported that staff were aware of their responsibilities in connection with safeguarding vulnerable adults and understood the companys whistleblowing policy. All staff who completed our survey said they knew what to do if they became aware of concerns. Since the previous key inspection, we had been made aware of one allegation of inappropriate behaviour towards a service user by a staff member. At this inspection visit the manager reported that the matter had been investigated and resolved, although documentary evidence of the outcome of the investigation had not been received from the social worker who was involved in the investigation. Discussion with the service user who had instigated the investigation confirmed that the matter was dealt with to her satisfaction. Care Homes for Older People Page 18 of 28 Evidence: Previous inspection visits have found the homes complaints procedure to be appropriate. The procedure was not looked at at this visit. The home keeps a log of complaints made which was looked at. All service users, visitors and staff, who were asked, expressed the view that any complaint would be taken seriously and investigated by the management of the home. One relative said they were confident that they could complain as they found staff to be outgoing. One service user said that she had been told to speak up if something was wrong and that it would be sorted. All service users who were asked, said that they felt safe, in that they were protected from abuse or exploitation. One service user, when discussing if she felt safe, described staff as good and understanding. All visitors who were asked believed that their relatives were safe, one saying very much so and another said that he did not need to give it any thought. Staff who were interviewed were confident that service users were safe and that they knew what to do in the event of becoming aware of any allegation or concern. All said that they had received some level of POVA (protection of vulnerable adults) training and that they were aware of the whistleblowing policy. Training records which were seen indicated that over half the staff had received POVA training in addition to the induction received by all staff, which included information on POVA. Care Homes for Older People Page 19 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is appropriately maintained, decorated and cleaned to enable service users to live in a pleasant, safe and hygienic environment. Evidence: Information provided in the AQAA stated that the home employed a full-time maintenance man, that maintenance logs were maintained and that policies and procedures were in place in connection with hygiene and infection control. At this unannounced inspection visit, a tour of the building was undertaken. We looked at communal areas and a selection of service users bedrooms. The home presented as clean and tidy with no unpleasant smells. All service users, visitors and staff spoken to, confirmed that this was the usual state of the building. No issues relating to the fabric of the building were identified as needing to be addressed. Policies and procedures in connection with hygiene and infection control were not looked at during this visit but have been found to be appropriate on previous occasions. One visitor commented that in their experience the building was always warm and when asked what the best thing about the home was said, plenty of staff and the Care Homes for Older People Page 20 of 28 Evidence: building is nice and very clean. Another visitor included among the best in the home the fact that it didnt smell. A service user said, while discussing their room, they clean the room every day. The cleaners work hard, are thorough and always give you a kind word. Care Homes for Older People Page 21 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Recruitment and vetting procedures are effectively applied to minimise the risk to service users of inappropriate staff being employed. The numbers and skills mix of staff on duty promotes the independence and well being of service users. Evidence: The AQAA stated that staff had an induction programme and the manager, the deputy and the unit manager reviewed the staff skill mix to ensure that care delivery was at its optimum within the staff team. All respondents to the staff questionnaire said that there are usually enough staff on duty. The manager reported that staffing levels were provided on the basis of, for the nursing floor, one nurse on shift at all times, three carers on between 08:00 -- 21:00 and two carers between 21:00 -- 08:00. An additional carer is provided on the nursing floor between 06:00 -- 08:00. On the residential floor five care staff were provided between 08:00 -- 13:00; four care staff between 13:00 -- 21:00 and two care staff between 21:00 -- 08:00. A copy of the staff rota for the week beginning 06/10/08 was provided as evidence that these levels are usually maintained. At the site visit the manager confirmed that in her opinion the staffing levels were appropriate to meet the identified needs of the service users. Some staff indicated that there were occasions when they were very busy and consequently not able to do as much socially with the Care Homes for Older People Page 22 of 28 Evidence: service users. However no service user or visitor identified staffing levels as a problem. One visiting relative identified as one of the best things about the home plenty of staff. One service user said you only have to ring and they are there. Computer records held at Langfield indicated that 22 of the 31 care staff held either NVQ II or NVQ III. These records also identified a further six members of staff were undertaking NVQ II and one was doing NVQ III. There was documentary evidence of a range of other training opportunities for staff and evidence that core, mandatory, training was undertaken. Staff who were asked, confirmed that they had received a range of training and expressed the view that the company was supportive of staff following further training opportunities. All staff who responded to the survey question about appropriate recruitment procedures indicated that they had been followed. Staff who were asked also confirmed that appropriate pre-employment checks were undertaken on new staff. A small selection of files relating to the recruitment procedures for relatively newly appointed staff was looked at. These mostly gave good evidence that the legally required checks were undertaken before staff were allowed to commence work. Some anomalies were identified where there did not appear to be any recorded questioning or explanation of those anomalies. Examples of this included a copy of a CRB (criminal record bureau) disclosure relating to employment at a different care home although that care home was not identified as previous employment on the application form, and an unexplained gap in employment history. All service users and visitors spoken to were positive about the approach and competency of the staff team. Comments included: staff are helpful and let you know if there is a problem ... [staff are] very patient with service users ... staff are very good and explain things to [X] ... staff are brilliant and look after you very very well. They are lovely. Care Homes for Older People Page 23 of 28 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The manager is competent to run the home, use the quality audit systems and implement the health and safety procedures for the benefit of service users and staff. Evidence: The AQAA, completed by the manager, said that she had completed the registered managers award; the home had a clear and accountable management structure; quality assurance audits were used to monitor all aspects of the service provided and that appropriate policies and procedures were in place. At previous inspection visits the manager has been found to be appropriately skilled and have an appropriate approach to running a care home for older people. At this visit she reported that she had successfully completed the professional qualification required but was still waiting for a certificate to be provided. The company procedures require that a range of regular audits are undertaken within Care Homes for Older People Page 24 of 28 Evidence: the home. There was some documentary evidence of this and the manager and operations manager confirmed that audits took place, including regular unannounced visits from the operations manager to ensure appropriate standards were being maintained. It is also company policy to regularly assess the results of surveys completed by service users and other people with an interest in the running of the home. No report of the outcome of this assessment could be located at the time of the visit. A sample of records relating to money held on behalf of service users was looked at. These presented as being appropriately maintained to safeguard the interests of service users and offered a clear audit trail including receipts for purchases made on behalf of service users. Previous site visits to Langfield have confirmed good standards of maintenance of equipment for health and safety purposes. Similarly there has been a regular routine of testing fire alarm and detection equipment. A small sample of documentation to demonstrate health and safety testing and compliance was looked at and presented as being appropriately maintained. No obvious health and safety problems were identified at this visit. Staff who were asked, confirmed the availability of personal protective equipment such as disposable gloves and aprons. They also confirmed that their use was compulsory to minimise the risk of cross infection. Care Homes for Older People Page 25 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 26 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 7 In order to ensure that staff have access to accurate written information to inform them of the care needs of each individual, care plans should be amended to reflect any changes in a service users circumstances. In order to be able to demonstrate that any allegation has been thoroughly investigated the manager should ensure that relevant documentation is received from any third party undertaking the investigation. Any gaps or inconsistencies in information supplied by potential employees should be thoroughly explored and documented. This is to ensure that the manager can demonstrate that all reasonable efforts have been made to protect vulnerable service users from the appointment of inappropriate staff. The quality assurance systems should be drawn together into one report which includes an action plan for how the management and staff at Langfield can further improve the service provided to the residents. 2 18 3 29 4 33 Care Homes for Older People Page 27 of 28 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 28 of 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!